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AM Palmowski, KW Ruprecht; Visual function in photodynamic therapy of CNV with Verteporfin . Invest. Ophthalmol. Vis. Sci. 2002;43(13):573.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Last year we reported on the development of visual function following an initial PDT in 16 eyes with a predominantly classic CNV. Paracentral visual function as assessed with the mfERG and with perimetry improved even in eyes with a stable visual acuity. Here we assess the influence of photodynamic therapy (PDT) on visual function in different forms of choroidal neovascular membranes (CNV) as well as over a slightly longer period of follow up. Methods:Prior to and following PDT for a subfoveal CNV, 42 patients underwent testing of Snellen visual acuity (VA) and central visual fields (Octopus d32) where mean defects (MD) and loss variance (LV) were analyzed. Results:Of these 42 patients 31 were affected with a predominantly classic CNV in AMD. These were followed for a mean of 7 months and received a mean of 1.8 treatments. While mean VA and MD remained stable, focal retinal sensitivity improved (mean LV pre PDT 28, post PDT 23). Here, 10 of the 20 patients with a reduction in VA, showed an improved LV. The marked improvement of the LV held true even when only the 8 subjects with a follow up of more than 10 months were analyzed. 5 subjects with an occult CNV in AMD were followed for a mean of 4.5 months and so far have undergone a mean of 1 PDT. Here mean VA improved from 0.2 to 0.3 as well as LV (33.8 pre PDT, 24.6 post PDT) while MD remained stable. Of the 2 patients with CNV in POHS one developed a reaction of the RPE following PDT and thus a marked worsening in her LV, while the other patient showed a marked improvement in VA and LV. 4 patients with CNV in association with myopia were followed for a mean of 7 months during which a mean of 1.5 PDT treatments were applied. This group improved in VA (from 0.3 to 0.5), in LV (from 15.4 to 4) as well as in MD (11.17 to 7.5). Conclusion:Consistent with the results of previous studies, VA improved most in classic CNV and high myopia. However, with visual field testing, improved retinal function was seen even in patients where VA was reduced following PDT. This improvement of LV was stable in a subgroup with a mean follow up of 12.5 months. Thus we suggest that testing of paracentral visual function be included in treatment trials of AMD.
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